Low Level Laser Versus Neural Mobilization of Brachial Plexus on Shoulder Dysfunction Post Liver Donation

Обзор

The purpose of the study will be to compare therapeutic effect of low level laser versus neural mobilization techniques on shoulder dysfunction post liver donation.

Подробное описание

The need for this study develops from the lack of information in the published studies about the effectiveness of low level laser and neural mobilization of brachial plexus on shoulder dysfunction post liver donation.

Following liver donation and transplantation, shoulder dysfunction and discomfort occur in 20% to 60% of patients.

Low-level laser therapy (LLLT) has been used as a non-pharmacological alternative to treat painful musculoskeletal conditions. It is used in acute, chronic painful and inflammatory affections shows that low energy irradiation from lasers alters cellular processes, producing anti-inflammatory effects and increased collagen turnover.

Neural mobilization (NM) is an intervention aimed at restoring the homeostasis in and around the nervous system, by mobilization of the nervous system itself or the structures that surround the nervous system. Neural mobilization facilitates movement between neural structures and their surroundings (interface) through manual techniques or exercise. Human and animal studies revealed that NM reduces intraneural edema, improves intraneural fluid dispersion, reduces thermal and mechanical hyperalgesia and reverses the increased immune responses.

The present study is designed to investigate the effect of LLLT versus NMT on shoulder dysfunction post liver donation.

Вмешательства

• Другое Low level laser therapy (LLLT)
  The first experimental will receive LLLT using the Fisioline Lumix 2 (Italy). Participants will be placed in a comfortable, supported sitting position and will wear protective eyeglasses to prevent retinal damage. The LLLT (GaAs type, 1-10 mW, 904 nm) will be applied to the most painful points on the deltoid and/or upper trapezius muscles. Treatment will target a minimum of two and a maximum of four painful points, with each point irradiated for 3-4 minutes, for a total session duration of up to
• Другое Neural mobilization techniques
  The second experimental will receive Neural Mobilization Therapy (NMT). The procedure will begin by positioning the patient in a sitting position. The initial positioning will involve placing the patient's arm at their side with the elbow bent at 90 degrees. The therapist will gently extend the patient's shoulder (moving the arm backward) while keeping the elbow bent, creating tension on the axillary nerve. This tension will be held for a few seconds, ensuring it remains within the patient's tol
• Другое Conventional physical therapy program
  The following exercises will be performed by the patients of three groups. Pendulum exercise, Isometric Scapular Retraction, Rotator cuff exercise, Wall creeping exercise, Active assisted ROM exercises, Codman exercises. Each exercise will be performed for all movements namely flexion extension and abduction-adduction, one sets of each 10-15 repetitions within pain-free range and instructed to carry out their activities of daily living.

Первичные конечные точки

• Arabic version of Shoulder Pain and Disability Index (SPADI) [Срок оценки: 4 weeks]

Вторичные конечные точки (4)

• Measurement of shoulder flexion range of motion (ROM) [Срок оценки: 4 weeks]
• Measurement of shoulder abduction range of motion (ROM) [Срок оценки: 4 weeks]
• Measurement of shoulder external rotation range of motion (ROM) [Срок оценки: 4 weeks]
• Measurement of maximum isometric force (MIF) of shoulder abductors [Срок оценки: 4 weeks]

Критерии участия

Критерии включения

• Patients are both males and females.
• Their age will range from (20-50) years.
• Patients will suffer from unilateral shoulder pain(Rt shoulder).
• Patients will begin the training program one week post.operative.
• All patients will suffer from moderate to severe pain (VAS score > 4).
• Patients will be given their informed consent.

Критерии исключения

• Known history of high level Spinal cord injury and malignancy
• Metabolic disease with a neurological component such as diabetes.
• Orthopedic disorders such as fracture or dislocation.
• Musculoskeletal disorders that will impair performance during training and tests.
• Uncontrolled cardiovascular or pulmonary diseases .
• Circulatory disturbances of upper extremity
• Psychiatric illness, severe behavior or cognitive disorders.
• Uncooperative patients.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

Египет · 1 центр

• faculty of physical therapy, Cairo University — Giza

Идентификаторы

NCT: NCT06703775 · P.T.REC/012/005253

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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